Re: Long-Term Prediction of Prostate Cancer: Prostate-Specific Antigen (PSA) Velocity Is Predictive but Does Not Improve the Predictive Accuracy of a Single PSA Measurement 15 Years or More Before Cancer Diagnosis in a Large, Representative, Unscreened Population

摘要

Experts' summary:Ulmert et al reported on prostate-specific antigen velocity (PSAV) in 4907 men from a preventive medicine study with two blood draws approximately 6 yr apart. The 20-yr probability of prostate cancer (PCa) diagnosis was strikingly different for men with a PSAV in the 50th percentile versus the 95th percen-tile (9.1% vs 14.1%). On receiver operating characteristic (ROC) analysis, however, the concordance index (c-index) for PCa diagnosis was 0.771 using prostate-specific antigen (PSA) alone and with the addition of PSAV. To predict advanced disease, adding PSAV to PSA increased the c-index marginally from 0.848 to 0.849.